What is Urinary tract infection (UTI) in children?

Urinary tract infections (UTIs) are common in children. A UTI starts in the bladder and then travels through the urethra and into the next part of the urinary system.

The urinary system includes the kidneys and the ureters. The kidneys filter waste out of the body and control the amount of liquid in the body. The ureters are the tubes that carry urine from the kidneys to the bladder.

What causes a UTI in a child?

A UTI can develop when bacteria get into the urinary tract. This can happen when a child is:

  • Urinating often (for instance, during a bladder infection or frequent urination)
  • Not drinking enough fluids
  • Not emptying the bladder completely
  • Having a baby
  • Having an enlarged prostate
  • Being sexually active

What are the symptoms of a UTI in a child?

Symptoms of a UTI can start suddenly or come on slowly. They can include:

  • Burning when urinating
  • A strong urge to urinate
  • Blood in the urine
  • Cloudy urine
  • Strong-smelling urine
  • Pain in the lower belly
  • Pain in the back or sides
  • Strong-smelling urine after going to the bathroom
  • Less urine stream
  • Urine that smells bad

What are the risk factors for a UTI in a child?

A child may be at risk for a UTI if he or she has a medical condition that affects the bladder, kidneys, or ureters. These include:

  • A bladder or kidney infection
  • A kidney or bladder cancer
  • A weak bladder
  • Kidney or bladder stones
  • An enlarged prostate
  • A blockage in the ureters

A child may also be at risk for a UTI if he or she has a recent change in diet, such as taking antibiotics.

How is a UTI diagnosed in a child?

Your child’s doctor can help to diagnose a UTI by taking a medical history and doing a physical exam. During the exam, the doctor will check for a fever and other symptoms that may be a sign of a UTI. The doctor may also feel the back or sides of the child’s pelvis. The doctor may also do a urine test.

The doctor may order one or more of the following tests to find out if the child has a UTI:

  • Urinalysis. This is done by looking at a sample of the child’s urine under a microscope.
  • Urine culture. This is done by taking a sample of the child’s urine and sending it to a lab to be checked for bacteria.
  • Urinary tract ultrasound. This is a test that uses high-frequency sound waves to create an image of the inside of the urinary tract.
  • Voiding cystourethrogram. This is a special X-ray that uses contrast dye to help show the kidneys, ureters, and bladder. It is used to check for a blockage in the ureters.
  • Kidney ultrasound. This is a test that uses sound waves to create an image of the kidneys, ureters, and bladder. It is used to check for stones in the bladder or kidneys.
  • Cystoscopy. This is a procedure in which a small, lighted tube with a lens on the end (cystoscope) is inserted into the urethra. The cystoscope is put in place using a special dye. The doctor views the bladder, ureters, and kidneys on a TV screen.
  • Kidney biopsy. A small amount of tissue is taken from the kidneys for analysis in a lab.
  • Urine cytology. A sample of the urine is checked for white blood cells. In some cases, this test is used to find out if a UTI is caused by a yeast or a fungus.
  • Fluid sample. A sample of the child’s urine is taken to be checked in a lab for bacteria or white blood cells.

How is a UTI in a child treated?

A UTI in a child usually requires treatment with antibiotics. The doctor may start the antibiotic treatment before doing the lab tests to find out if the child has a UTI.

Your child’s doctor may prescribe one of these:

  • Cephalexin (Keflex)
  • Azithromycin (Zithromax)
  • Doxycycline (Adoxa)

The doctor will likely also give your child a medicine to help him or her pass a urine. Your child’s doctor may also recommend that you limit your child’s fluid intake for a day or two. This will speed up the child’s recovery and may also prevent a blockage in the ureter from forming.

Your child’s treatment will depend on the type of UTI and whether it is a serious infection.

Long-term medications

Your child may need to take antibiotics for a long time to clear a UTI. This is because some infections, such as kidney infections, don’t go away.

Your child may also need to take a medicine to help make sure that he or she has a full bladder and can empty the bladder. This medicine is called a bladder control medicine. Your child may need to take this medicine for the rest of his or her life.

Surgery

If a child has a serious infection or a blockage in the ureter, he or she may need surgery to remove the blockage. This is called an endoscopic laser surgery.

The doctor will put a thin tube with a camera on the end (endoscope) into your child’s urethra. The camera will show the doctor where the blockage is. The doctor will then use a special instrument to remove the blockage.

Your child’s recovery will depend on the type of surgery he or she had.

How can I help prevent a UTI in my child?

You can help keep your child from getting a UTI by:

  • Not emptying the bladder too often.
  • Drinking lots of fluids.
  • Urinating often.
  • Drinking plenty of water.
  • Avoiding having a baby.
  • Not emptying the bladder too quickly.
  • Always emptying the bladder after a bowel movement.
  • Avoiding sexual activity.
  • Not having sexual intercourse when your child is not feeling well.

When should I call my child’s healthcare provider?

  • New symptoms or symptoms that get worse
  • Signs of an infection that do not get better

Key points about UTIs in children

  • A urinary tract infection (UTI) is an infection of the bladder, kidneys, or both.

Closing thoughts

A UTI is an infection that starts in the bladder or urethra. It can then travel down the urinary tract and cause other infections.

A UTI can be serious and need to be treated with antibiotics.

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